Family doctor model in health insurance: Explanation

In the health insurance scheme's family doctor model, your family doctor is at the centre of your medical care. You choose a family doctor of your choice who becomes your first point of contact for medical concerns. When health problems arise, you make an appointment with your family doctor, who examines your symptoms, makes a diagnosis and recommends the appropriate treatment. If necessary, your family doctor will refer you to specialists and coordinate all your medical care.

The family doctor model offers three significant advantages: First, it ensures continuous and well-coordinated care, which can have a positive impact on your health. Second, it can reduce your health insurance premiums by up to 20%, which means financial relief. Thirdly, it promotes a long-term relationship with your family doctor, who knows your medical history and can make informed decisions for your health.

Your commitment under the family doctor model is to choose your family doctor as your first point of contact for medical issues, and you should go to him or her first when you need medical support. In most cases, you will need to contact your family doctor first when visiting a doctor, but there are exceptions, such as emergencies or special medical situations, where you can go directly to a specialist.

Family doctor model
21.03.2024  |  Reading time: 4 Minute

What is the family doctor model?

The family doctor model is a model in health insurance where your family doctor is the first point of contact for your medical care. In the family doctor model, you must first contact your family doctor if you have health problems or need medical help. Your family doctor monitors your health, gives advice and refers you to specialists if necessary. The aim of the family doctor model is to coordinate medical care and ensure that you receive the right treatment.

How does the family doctor model work?

You choose a family doctor who becomes your first point of medical contact. You make an appointment with your family doctor when you have health problems. Your family doctor will examine your symptoms, make a diagnosis and recommend the necessary treatment. Your family doctor will refer you to a specialist if specialist knowledge is needed. Your family doctor coordinates your medical care and keeps track of your health.

What are the advantages of the family doctor model?

The biggest advantage of the family doctor model is that the family doctor provides continuous and coordinated care, which can improve your health. The second advantage is that the family doctor model reduces the premiums of the health insurance company by up to 20%. The third advantage is that the family doctor model promotes a long-term relationship with your family doctor, who knows your medical history and can make better decisions.

What are my obligations with the family doctor model?

Your obligation under the family doctor model is to choose your family doctor as your first point of contact for medical questions and problems. You should go to your family doctor first when you need medical help. A referral to a specialist should be made through your family doctor.

Do I have to contact my family doctor first every time I visit a doctor?

Yes, you should contact your family doctor first before seeing a specialist. Your family doctor is your first point of contact for your health problems.

How do I find a family doctor for the family doctor model?

Choosing a family doctor for the family doctor model is easy. You can get a list of family doctors in your area from your health insurance fund. Choose one that you like and inform your health insurance company of your choice.

Are there exceptions where I can go directly to a specialist?

Yes, there are exceptions, such as emergencies or special medical conditions, where you can go directly to a specialist without consulting your family doctor first. In urgent cases, your health always comes first.

What happens if I need medical help outside my family doctor's office hours?

If you need medical help outside your family doctor's office hours, there are usually emergency services or clinics you can go to. In emergencies, do not hesitate to seek medical help immediately.

How does billing work in the family doctor model?

Billing in the general practitioner model usually takes place via your health insurance fund. As a rule, you do not have to pay any fees directly to your family doctor; instead, your health insurance company covers the costs.

Are the health insurance premiums in the family doctor model cheaper than the standard model?

Health insurance premiums are up to 20% cheaper in the family doctor model than in the standard model. You can use the health insurance comparison to find out about the current premiums.

Frequently asked questions about the family doctor model in health insurance

The frequently asked questions about the family doctor model are listed below:

Yes, in an emergency you can go directly to hospital without contacting your family doctor first.

All health insurance companies offer the family doctor model in Switzerland. You can ask your health insurance company about the available options.

Yes, you can usually change the family doctor model if you are dissatisfied with your current family doctor or your needs change. Simply contact your health insurance company to discuss the change.

Yes, there can be differences between the family doctor models of different health insurance companies. The exact details and conditions may vary depending on the health insurance company. It is advisable to ask your health insurance company about the specific modalities.

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